Dupuytren Contracture

Overview

Dupuytren’s Contracture is a progressive condition affecting the connective tissue beneath the skin of the palm and fingers. Over time, this disorder can lead to permanent deformities, restricting hand function and affecting the quality of life.

Introduction

Named after French surgeon Guillaume Dupuytren, who described the condition in the 19th century, Dupuytren’s Contracture involves the thickening and tightening of the palmar fascia, a layer of connective tissue in the hand. Though commonly seen in Western countries, recent data indicates a growing prevalence in India, possibly linked to aging populations and genetic factors. This condition is more prevalent among men over 50, but women and younger individuals are not immune.

Symptoms

Dupuytren’s Contracture typically begins with subtle signs that progress over time. Key symptoms include:
– Formation of lumps or nodules under the skin of the palm.
– Thickened cords of tissue that may pull one or more fingers into a bent position.
– Difficulty in extending affected fingers fully, particularly the ring and little fingers.
– Mild discomfort or tenderness in the early stages, although pain is generally uncommon.

Causes

While the exact cause remains unclear, several factors contribute to the development of Dupuytren’s Contracture:
– Genetic predisposition: The condition often runs in families.
– Age and gender: Men over the age of 50 are at higher risk.
– Lifestyle factors: Tobacco use and alcohol consumption are associated with higher risk.
– Medical conditions: Individuals with diabetes, epilepsy, or chronic liver disease may be more susceptible.

Treatment

The treatment for Dupuytren’s Contracture varies depending on the severity of the condition:
– Non-Surgical Approaches:
– Physical therapy: To maintain mobility and prevent stiffness.
– Collagenase injections: Enzymatic treatment to break down thickened cords.
– Surgical Options:
– Fasciotomy: Cutting the thickened cords to improve finger mobility.
– Subtotal or total fasciectomy: Removal of the affected tissue for severe cases.
– Dermofasciectomy: A more complex procedure involving skin grafting, often recommended for recurrent cases.

Prevention and Risk Factors

While prevention is not always possible, early intervention and lifestyle changes can minimize risks:
– Hand care: Regular stretching exercises for fingers and hands.
– Healthy lifestyle: Avoiding smoking and limiting alcohol intake can reduce the risk.
– Medical monitoring: Regular check-ups for individuals with diabetes or other risk factors.
– Ergonomic tools: Using tools that reduce hand strain, especially for people engaged in manual labor.

Insights from Sancheti Hospital

At Sancheti Hospital, our team of orthopaedic specialists employs advanced diagnostic techniques and personalized treatment plans for Dupuytren’s Contracture. With state-of-the-art facilities and minimally invasive surgical options, we aim to restore hand functionality and improve the quality of life for our patients. Our emphasis on post-operative care and rehabilitation ensures a smooth recovery process.

Resources and References

1. Mishra A., et al. (2020). Dupuytren’s Contracture in India: An Emerging Concern. Journal of Orthopaedic Research.
2. Health Statistics in India (2022). Indian Council of Medical Research (ICMR).
3. Sancheti Hospital, Pune – Clinical Expertise in Orthopaedics.